Cortical blood flow recorded during early or delayed surgery for ruptured intracranial aneurysms.

Forty-three patients were operated on for ruptured intracranial aneurysms during a 12-month-period. Intraoperative evaluation of cortical blood flow by means of a thermal diffusion probe was performed in 23 out of the 41 patients who were operated on for aneurysms of the anterior circulation. The autoregulation index was determined at the time of raising the systemic blood pressure after clipping of the aneurysm(s). No statistically significant difference was found between the averages of the autoregulation indexes calculated in the subgroups of patients submitted respectively to early or delayed surgery. There was no correlation of both cortical blood flow and autoregulation with either age of the patients, or preoperative neurological grade. On the contrary, the autoregulation index showed a statistically significant correlation with outcome.

[Intra- and postoperative cerebral blood flow in patients with subarachnoid hemorrhage from a ruptured aneurysm]. / Flusso ematico cerebrale intra- e postoperatorio in pazienti con emorragia subaracnoidea da fissurazione di aneurisma.

The CBF of eight patients, who underwent surgery for ruptured aneurysm, was monitored using the termodiffusion technique (TDF). The device employed in this investigation allowed a continuous monitoring in "real time" of the cortical flow. The purpose of the study was to detect disorders of autoregulation, which were evaluated with the autoregulation index (AI). Autoregulation was correlated with the neurological preoperative grading, the postoperative changes of CBF (Xe133 clearance) and the outcome. The results of this preliminary study showed a correlation between these parameters and stressed the value of CBF monitoring during surgery.